Clean needle exchanges, safesex education, and drug
abuse treatment are powerful weapons against the AIDS
epidemic, but their effectiveness is being blocked by moral
and government objections, a panel of experts concluded.The
committee selected by the U.S. National Institutes of
Health (NIH) cited strong scientific evidence that members
said prove the effectiveness of behavior modification
programs in slowing the AIDS epidemic. The 12member panel
urged leaders at all government levels to change policies
that prevent use of what they called "lifesaving public
health strategies." "The AIDS epidemic is a current and
pressing public health emergency" that can be lessened by
behavior modification programs, said Dr. David Reiss,
George Washington University Medical Center, Washington,
D.C. Reiss has identified "significant policy and legal
barriers that must be removed in order for these
interventions to protect the population from the spread of
AIDS."

He said strong scientific evidence shows that programs
of safe sex education and clean needle exchanges "are
very effective means to prevent the spread of HIV ...
infection into the most susceptible populations."

"I completely reject this," said Robert L. Maginnis,
Family Research Council. He said evidence of how well
needle exchanges and safe sex programs work remains
inconclusive and often involves "faulty science."

Reiss and his committee proposed an immediate change of
regulations banning federal support of clean
needleexchange programs. "There is no valid scientific
basis for such policies," said Reiss. "Thousands of lives
are at risk if this ban is not removed."

In its report, the NIH committee found that clean
needleexchange programs in New Haven, Connecticut, and in
Amsterdam, The Netherlands, did not lead to increased drug
use, encourage young people to start using drugs, or cause
more needles to be discarded in public places.

Such programs did reduce by 80 percent the amount of
needle sharing among drug users, the committee found,
leading to an estimated 30 percent reduction in new HIV
infections.

About 100 needleexchange programs are active in the
United States, compared to 2,000 in Australia, a country
with only onetenth the U.S. population, the report said.

Maginnis said his studies show a needleexchange
program in Connecticut did lead to increased drug abuse, to
more discarded needles, and to a rise in petty crime in
some neighborhoods.

A federal welfare law that permits only the teaching of
abstinence in sex education also should be changed, said
Reiss. "It is not consistent with the scientific findings"
of effective teaching tools for young people on how to
avoid an HIV infection, he said.

He said safe sex education, which can include
recommending using condoms and limiting partners, is the
most effective way to reduce the sexual spread of AIDS. A
program among innercity women, the report said, led to
doubled use of condoms. And a study in Tanzania showed a 50
percent drop in HIV spread among young women after a condom
distribution program began.

Maginnis said that pushing condom use is "like playing
Russian roulette" because, he said, many condoms fail.
"Abstinence is the only effective way of keeping people
from contracting HIV," Maginnis said.

The committee recommended additional research into how
to prevent HIV infection in populations whose sexual
behavior is little understood.

"Little is known about the risk behaviors of lesbians
and bisexual women, heterosexual men, persons over 50 years
old, and sexually active youth," the study said.

The committee drew up the report after three days of
evaluating scientific literature and hearing testimony from
experts.